Skilful communication: Emotional facial expressions recognition in very old adults.

OBJECTIVES: The main objective of this study was to assess the changes associated with ageing in the ability to identify emotional facial expressions and to what extent such age-related changes depend on the intensity with which each basic emotion is manifested. METHODS: A randomised controlled trial carried out on 107 subjects who performed a six alternative forced-choice emotional expressions identification task. The stimuli consisted of 270 virtual emotional faces expressing the six basic emotions (happiness, sadness, surprise, fear, anger and disgust) at three different levels of intensity (low, pronounced and maximum). The virtual faces were generated by facial surface changes, as described in the Facial Action Coding System (FACS). RESULTS: A progressive age-related decline in the ability to identify emotional facial expressions was detected. The ability to recognise the intensity of expressions was one of the most strongly impaired variables associated with age, although the valence of emotion was also poorly identified, particularly in terms of recognising negative emotions. CONCLUSIONS: Nurses should be mindful of how ageing affects communication with older patients. In this study, very old adults displayed more difficulties in identifying emotional facial expressions, especially low intensity expressions and those associated with difficult emotions like disgust or fear.